A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

Abstract

BACKGROUNDTo develop and validate a nomogram based on log of odds between the number of positive lymph node and the number of negative lymph node (LODDS) in predicting the overall survival (OS) and cancer specific survival (CSS) for epithelial ovarian cancer (EOC) patients.MATERIALS AND METHODSA total of 10,692 post-operative EOC patients diagnosed between 2004 and 2013 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training (n = 7,021) and validation (n = 3,671) cohorts. Multiple clinical pathological parameters were assessed and compared with outcomes. Parameters significantly correlating with outcomes were used to build a nomogram. Bootstrap validation was subsequently used to assess the predictive value of the model.RESULTSIn the training set, age at diagnosis, race, marital status, tumor location, stage, grade and LODDS were correlated significantly with outcome in both the univariate and multivariate analyses and were used to develop a nomogram. The nomogram demonstrated good accuracy in predicting OS and CSS, with a bootstrap-corrected concordance index of 0.757 (95% CI, 0.746-0.768) for OS and 0.770 (95% CI, 0.759-0.782) for CSS. Notably, in this population our model performed favorably compared to the currently utilized Federation of Gynecology and Obstetrics (FIGO) model, with concordance indices of 0.699 (95% CI, 0.688-0.710, P < 0.05) and 0.719 (95% CI, 0.709- 0.730, P < 0.05) for OS and CSS, respectively. Using our nomogram in the validation cohort, the C-indices were 0.757 (95% CI, 0.741-0.773, P < 0.05, compared to FIGO) for OS and 0.762 (95% CI, 0.746-0.779, P < 0.05, compared to FIGO) for CSS.CONCLUSIONSLODDS works as an independent prognostic factor for predicting survival in patients with EOC regardless of the tumor stage. By incorporating LODDS, our nomogram may be superior to the currently utilized FIGO staging system in predicting OS and CSS among post-operative EOC patients.

Survival effect of different lymph node staging methods on ovarian cancer: An analysis of 10 878 patients

“…[19][20][21][22][23] Little is known about the role of LODDS in ovarian cancer. Xu et al 24 found LODDS as an independent prognostic factor for predicting survival in patients with EOC regardless of the tumor stage. Although LODDS exhibits discriminatory ability in predicting survival, there is no study concerning the diverse role of LODDS in different FIGO stages.…”

“…In FIGO stage I, a large number of resected lymph nodes did not represent a better outcome. The patients with [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] RLNs have the best prognosis. When RLNs numbered more than 30, the survival rate decreased.…”

“…Therefore, increasing attention has been paid to lymph node status, which can be evaluated by the number of resected lymph nodes (RLNs), lymph node ratio (LNR), and the log odds of positive lymph nodes (LODDS) . Compared to a single parameter, LNR exhibits its advantage in breast, pancreatic, colon, and ovarian cancers.…”

“…Compared to a single parameter, LNR exhibits its advantage in breast, pancreatic, colon, and ovarian cancers. Another parameter, LODDS, showed superiority in predicting outcomes in breast, pancreatic, colorectal, and ovarian cancers.…”

“…Therefore, increasing attention has been paid to lymph node status, which can be evaluated by the number of resected lymph nodes (RLNs), 15 lymph node ratio (LNR), [16][17][18] and the log odds of positive lymph nodes (LODDS). [19][20][21][22][23][24] Compared to a single parameter, LNR exhibits its advantage in breast, [25][26][27][28] pancreatic, 19 colon, [29][30][31][32] and ovarian 16,18 cancers. Another parameter, LODDS, showed superiority in predicting outcomes in breast, 20 pancreatic, 19,21 colorectal, 22,23 and ovarian 24 cancers.…”